Wednesday, August 27, 2014

One Pill, Two Pill, Red Pill, Blue Pill

I don’t write about medication much. Okay, ever. It’s a controversial topic (not that this has ever stopped me), that people in mental health, and in society in general, tend to feel strongly about. Oddly, despite the fact that I’m generally quite an opinionated person, my thoughts on this topic aren’t so steadfast, at least when it comes to the topic overall. I do, however, have a strong belief about my own treatment, and that includes medication. I also feel strongly that medication shouldn’t be a taboo and isn’t something to be ashamed of, and that’s why I decided to finally write about it.

First, a little background on my own treatment. I was diagnosed because of medication. The wrong medication. I had been given anti-depressants by my GP, and these were increased when I went to the ER several months later with what I thought were panic attacks. I stayed in the hospital for two days, with doctors insisting that I needed to increase my meds to help calm my depression, and me insisting that it wasn't depression and that I didn't need more meds because they actually made me feel worse. After two days the doctors felt proud of themselves that they'd "helped me with my depression" and sent me on my way, taking twice the amount of antidepressants than I'd come in with. I still insisted they were wrong. Turns out, I was right. What I was experiencing were actually undiagnosed hypomanic episodes. The severity of them - noticeable enough to send me to the ER - was due to my anti-depressants. See antidepressants, in the vaguest of terms, elevate your mood. In hypomanic episodes, your mood is already elevated. It doesn’t take a brain surgeon to put two and two together - elevated moods plus a medication designed to elevate your mood equals excessively-elevated moods. The key word here is excessively. As in unhealthy. I started going back to my therapist, and it was she who finally figured out what was going on. She diagnosed me with rapid-cycling cyclothymia, slowly brought me down off of the antidepressants completely, and began the correct treatment.

Now a little about my meds. (For the record, they’re yellow and off-whitish, as opposed to red and blue, but that didn’t rhyme so well). They’re actually anti-seizure meds. So if you’d like to think of my condition in simple terms, think of it as frequent seizures with an internal manifestation instead of an external one.  They work by limiting sodium release, which is needed for certain nerve cells to fire. As sodium release is more tightly controlled, so is the nerve cell firing in the brain, and that helps control my cycling. This is obviously a lay person's description, not the official medical terms. My meds are used only to prevent or limit hypomanic episodes. They generally don’t do so enough to bring me into depressive ones, which is lucky. I can’t be on antidepressants because I cycle too quickly, so by the time they’d take effect, I could be hypomanic again, and I’ve just described how that goes.

I know that there are people out there who don’t believe in using meds for mental health, or anything, for that matter. There are people who think that all mental health conditions can be treated "naturally"- either by diet and exercise, positive thinking, or even just with therapy without meds. Perhaps that’s true for some people, and I truly am happy that they can do that. But I am not one of them. My meds have saved my life. Let me repeat that: my meds have saved my life. They’ve brought back the sense of “normalcy,” for lack of a better word. As in, I don’t feel like my life is one continuous panic attack with an occasional bout of “I can’t get out of bed, my life is useless” thrown in for good measure.

Oh, there are side effects. Not terrible, as far as side effects go. There’s the usual dizziness, disorientation, nausea, along with the possibility of hyponatremia (low sodium levels) and seizures. I occasionally can’t feel my tongue and lips or get tingling in my fingers for a bit after taking my meds. I get nightmares and bad/intense dreams much more often, and I wake up looking like I just went for a swim, which is always super sexy. There’s even the rather rare possibility of developing a life-threatening skin disease called Stevens-Johnson syndrome. But I don’t have the more common side effects found in some meds, like uncontrolled weight gain or horrible dry mouth or stomach issues (I have stomach issues anyways, but it’s unrelated to my meds). I don’t feel dull or emotionless or like I’ve lost my creativity and inspiration, like I’ve heard some people say about being on meds. I also was lucky in that I found a med that worked for me on the first try. That’s very unusual in mental health medication treatment, and I feel very fortunate, overall.

I’m not writing this to convince anyone to take the meds I’m on, or to take meds at all. It’s not a rally against the “nobody needs meds” people. But I know plenty of people who feel that meds would help, except they are not quite ready to take the plunge into medication. For many people, I think it feels like the point of no return. I think, in a way, starting medication makes you admit to yourself that you really do have this condition, and that’s a tough step to take. Even with a diagnosis, it's not all that difficult to think to yourself "if I try hard enough I can make this go away." But taking meds makes it more "real" somehow. People feel they should be able to battle their condition on their own, and that something’s wrong with them that they can’t. They think that perhaps if they get a different perspective, think more positively, eat differently….  

But if you had diabetes that required insulin or asthma that required an inhaler, would you feel ashamed? Would you try to just fix it on your own? Yes, perhaps there are things that you could do in your day to day life that would help you feel better. But at the end of the day, you may need some medication to help straighten out your blood sugar or your breathing. There’s nothing wrong with that. Some medical conditions, because of their nature, require treatment that may include medication. Mine is one of those. I’m not ashamed; I’m grateful. I’m grateful that there is a medication out there that can help, and that my therapist suggested it to me. Do I believe that we should all have a spare bottle of Xanax lying around for every time we feel the slightest bit nervous? Not at all. But I do believe that taking the prescribed medication, at the prescribed intervals, in the prescribed amount, can be incredibly beneficial for some people, including me.

I’m happy to talk about medications more privately if anyone would like. I can only offer my opinion and my experiences. I’m in no way a medical doctor, and can’t advise on specific medications or anything of the like. However, I am happy to listen and to share my stories, in hopes that they may somehow help others.

Tuesday, August 19, 2014

I'll Dump Ice On My Head... I'm Not Forcing You To

My grandfather died of ALS.

He was 54. He’d had a really shitty upbringing and life handed him a death sentence at the age of 52. And it was painful, horrible death sentence. He wasn’t out having a great day one day and suddenly got hit by a bus and killed instantly. His body deteriorated until he could barely speak, could barely move. He wasted away in front of his family. He knew he was wasting away, he knew he was dying, and there was nothing anyone could do to stop it. When diagnosed, he was given two years to live. He died almost exactly two years to the day. On his son’s birthday. My mom lost her father at the age of 24. Her youngest sibling was in her teens. My grandmother was a widow in her early 50s. Only three of us grandchildren had ever met him when we were very young (I was 10 months old), and none of us remember him at all. All of us grandchildren grew up without a grandfather on that side of the family. We celebrated every holiday I can remember for the first 16 years of my life at my grandmother’s house… without him. I think I’ve painted the picture well enough, so let me continue.

I have been challenged to do the ice bucket in the name of ALS, and I’m excited to embarrass myself on video in the name of this cause. I’ve already given my donation that goes along with it (see point number 1 below). I’m waiting to do the ice bucket because my uncle is visiting this weekend and I thought I’d give him and my mom the honor of dumping the ice on my head, since it was their father that passed from ALS. I’ll add that humorous video when I do it.

Ok, so let’s move on to why I’m frustrated to the various negativity towards the challenge:

1. To those who say “donate instead”: Please understand the challenge correctly. You’re supposed to donate either way. If you do the ice bucket, it’s $10. If you don’t, it’s $100. There are several reasons many people do choose bucket option. A lot of people don’t have an extra $100 lying around for a charity they’d never thought of before. But a lot of people have $10 and ice lying around. Also, the ice bucket is fun and something people will post to let others know about the charity, so it gets others to donate that might normally not. And if you say that people might have planned to give more but now they only think they have to give $10 with the ice bucket….No.  They’re not going to say “well I was going to be super generous and give $100, but now I’m just going to dump ice on my head and give $10.” If they’re giving that much, it’s a charity they really want to support monetarily, probably because it’s affected them personally in some way. The ice bucket won’t change that.

2. To the “you’re wasting water!” people: I don’t put ice in my drinks because I hate super cold drinks. So all that ice I could put in my soda, water, adult beverage…. mine was just used for charity. Also, did you see those videos of Detroit underwater last week? That storm that came this way.. it rained for several days straight. It’s hurricane season here on the east coast. Do you know what hurricanes mean? Rain! Water! We on the east coast, and much of the country, have no shortage of water at the moment. If you’re in a drought state fighting forest fires, I’m ok with this objection. If you donate every month to Charity Water, I’m ok with this objection. If you opt not to take that extra shower before you go out with your girlfriends/buddies/date to look nicer because saving water is so important to you, I’m ok with this objection. If you have a rain bucket in your backyard and use that water for your food/drinks/teeth brushing, bathing… I’m ok with this objection. But if you’re sitting here watching the forecast that says 60% chance of rain at the end of the week, drinking ice in your drinks, not scrambling through a shower to use less water, not donating to water charities, then I have trouble with this objection.

3. The “it’s attention seeking” objection: I can’t even put my pisssed-offness into words about this. See, I really mean it… I had to just make up the word pissed-offness. I have actually seen people say that they think the ice bucket is attention seeking and in the same post where they put a screenshot of their donation amount and say “instead I just donated xyz amount!” So let me get this straight… you think doing something fun/silly to grab people’s attention and spread the word (while also donating) is attention seeking, but saying “look how much I donated!” and posting a picture of it isn’t? You’ve got to be kidding me! (For the record, I’m not judging either action, I’m just appreciative you did something, but if you’re calling one attention seeking, so is the other).

4. The “It’s not actually teaching people about ALS, just raising money” objection: In a way, these people are right - perhaps not everyone who does this is actually reading the information on the website. In fact, a lot of people probably aren’t. But guess what - same is true for people who just fill in a credit card form online or buy cookies at your fundraising bake sale. You can’t force people to be aware. You can do things to bring attention to the cause, and go from there. And if you raise a ton of money along the way, isn’t that what fundraising is? So if you’re objecting to the specific wording of “it raises awareness of ALS” you might be right that people may not be learning a ton more about the disease itself. But it certainly raises awareness of the foundation and the cause. I’ve never, in almost 35 years, seen so many people talking about ALS, and from what I’ve read, the foundation has never seen such an increase in donations.

5. The “some people don’t donate and just do the bucket” objection: So freaking what? The people who don’t donate most likely weren’t going to do anything at all for ALS. Now at least they’re doing something to make people aware of the challenge and suggest a donation, even if they don’t have the means to donate themselves. As I said in point one, they aren’t people who were going to donate a ton and then say “you know, instead I’ll just dump ice on my head.” But maybe they’ll pass it along to someone who will donate.

I want to be one hundred percent clear that I am not expecting every human to dump ice on their heads in the name of ALS.  If you don’t want to pour the ice over your head, or you don’t get the point of it, if you’d rather just donate without the ice bucket, or if you say “instead of the ice bucket I’m going to dress up in a chicken costume and dance around on video in the name of ALS”, I’m perfectly ok with that. I’m thankful that people are doing anything to raise awareness and/or funds about ALS. I don’t even mind if you post your donation amount (or your chicken costume video or whatever you decide to do). I don’t think it’s attention-seeking, I think it spreads the word. But please stop with all the hate posts and negativity about the people doing the ice bucket. It’s fun, at least to them, it’s for charity, and it’s helped the foundation raise a ton of money in the short time it’s been going on.

I’m sure there are people who I’m going to upset with this post. It’s not directed at any one person. I tried to sit quietly and let the negativity die down, but it’s just increasing. If you’ve posted an anti-ice-bucket meme/post/tweet, it’s nothing personal against you. I still like you as a person and hopefully you still like me. But I had to write about it. People aren’t killing or burning down buildings in the name of their cause. They’re dumping ice. On their own heads. Not yours. They’re not forcing you to participate, they’re doing so themselves. So please, let the ice-bucketers raise awareness and funds in the way they’d like, and you do so in the way you’d like. I’m grateful for all of it.

Wednesday, August 13, 2014

No Shoes, No Shirt, No Problem

Last week I went on vacation with my entire immediate family to St. Simon's Island. By "entire immediate family", I mean my parents, all five of us siblings, all of our significant others, and each family's kids. As we don't all live in close proximity, it's not often that we manage to get the whole crew together - probably every couple of years or so.

St. Simons Island, if you're not familiar with it, is a small island off the coast of Georgia that's rather historic and, while it offers beach rentals, is not built up like many other beach rental destinations. Sure, there are a few cheap beach shops and kayak rental places, but the majority of the island seems to actually live there, at least part of the year. It has a more "off the grid" kind of feel.

As you may know, I often times have a tough time unwinding. I can get lost in a good book for hours, or spend some time in quiet contemplation writing or meditating, but "chilling out" isn't really my thing. Partly, I think it's my general type A personality. Partly, it's my cyclothymia. My brain is always going. I mean always. Reading works because it gives my brain a story to get enraptured with. The same with writing. Meditation works because, quite frankly, I don't do it for all that long, and even then, I'm much better with guided meditation which allows me to focus on a story, than I am just sitting there quietly. In day to day life, I'm the queen of sticky notes, calendar reminders, and"to do list" alerts on my phone. I have numerous methods of jotting down notes, thoughts, or things I must remember at any given time. My phone, computer, and ipad are never far from my sight, lest I miss an email, text, or push notification. I am made instantly aware of the Facebook comments on the comment to my comment - and get an email about it in case I miss the push notification. When I put it in writing, I have to admit, it sounds a bit over the top.

So two Fridays ago, when we left on our drive to Georgia, I did something remarkable: I ensured that my Out of Office messages were enabled, shut down my computer, and turned off almost all of my push and email notifications, including those for social media. As I got into the swing of the week, surrounded by loved ones, the sun, the sand, and the casual way of life on the island, I left all of my electronics for hours at a time. A couple of days into the trip, I all but abandoned shoes, and barely wore anything except my bathing suit during the day and pjs at night. I relished coming downstairs in the mornings to the chatter of my family - usually my parents and a couple of the kids who arose earliest - and the smell of coffee brewing. I began to let myself be free of the "rules" I somehow managed to create for myself about constantly being in contact with everyone and having to constantly be working on something. I didn't worry about the workouts I was missing or the extra few calories I was eating, because I knew it was temporary. Eventually, I'd have to get back to "real life". Without realizing it, I was absolutely "working" on something - my peace of mind.

I was incredibly sad to leave the island, and the family. Being with people who love all of me, including my condition, as opposed to despite it, was incredibly healing. I felt free to completely be myself for the first time in ages. Upon returning, I chose to keep a large number of my push and email notifications turned off.  Oddly, the decision wasn't as difficult as I thought it might be. Yes, I now have to check for work and client emails more frequently. Yes, I have to watch a bit more carefully what I eat, and include a bit more activity in my daily routine. But I'm forcing myself to re-examine the rules I've set for myself and ask myself why they are there in the first place. Are they really helping me? Now? In the long run? I'm also trying to retain a bit of that sense of love, acceptance, and self-freedom that I acquired there. It's tough for someone like me who's never had a whole lot of self love and confidence to begin with, but I'm trying.

I realize I can't be on vacation every day, and that we must, of course, earn the money to take those kinds of vacations in the first place. I'm back to work at my part time job and back to running my company. I haven't completely abandoned my computer or my phone.  But perhaps now, when I do pick up my phone, I'll be more likely to choose my meditation app, or my skyguide app that allows me to find all of the constellations in their current locations, instead of replying to that Facebook comment on a comment of a comment.

The beach on St. Simons Island on an overcast day.